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Bendtsen M, McCambridge J. Reducing Alcohol Consumption Among Risky Drinkers in the General Population of Sweden Using an Interactive Mobile Health Intervention: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e13119. [PMID: 30998221 PMCID: PMC6495288 DOI: 10.2196/13119] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/28/2019] [Accepted: 03/03/2019] [Indexed: 12/25/2022] Open
Abstract
Background Harmful use of alcohol continues to be a leading contributor to premature deaths globally. Not only does harmful drinking have consequences for the individuals consuming at increased levels, but it may also result in a range of negative consequences for their family members and friends. Interventions delivered via mobile phones (mobile health [mHealth] interventions) could potentially support risky drinkers seeking help to reduce their alcohol consumption. Objective This protocol describes a randomized controlled trial that aims to validly estimate the effect of a novel mHealth intervention targeting risky drinkers in the general population of Sweden. Nested within the trial are 3 substudies that focus on methodological and user satisfaction research questions. Methods A 2-arm parallel group randomized controlled trial will be employed to estimate the effect of the novel intervention. Participants will be recruited through Web advertisements and social media. The inclusion criteria are as follows: 18 years or older, ownership of a mobile phone, and being classified as a risky drinker according to Swedish guidelines. Participants allocated to the intervention group will receive a novel mHealth intervention. The intervention consists of weekly screening, personalized feedback on current consumption, functions allowing for planning of future consumption, as well as a series of messages delivered throughout the week. Participants allocated to the control group will receive a short message regarding negative consequences of alcohol consumption and a hyperlink that offers more information. Following 2 and 4 months after randomization, both groups will be asked to complete follow-up questionnaires (2-month interval being primary). Primary outcomes are weekly alcohol consumption and heavy episodic drinking. Participants in the control group will be given access to the novel intervention after completing the 4-month follow-up. The trial includes 3 substudies: We will explore whether the mode of presenting information before participants giving informed consent affects participation rates and recall of trial parameters, investigate if the content of the short message received by the control group affects study outcomes and requests for more information, and explore user satisfaction with the intervention and reactions of the control group. Results Participant recruitment is planned to begin in April 2019 and to last for a maximum of 24 months. The first dataset will be available approximately 2 months after the final participant has been recruited, and the final dataset will be available approximately 2 months later. No participants had been recruited at the time of submitting this protocol. Conclusions If found effective, the intervention has the potential to reduce negative consequences of alcohol consumption for individuals. The technology has been designed to have potential for extensive reach among those who may benefit. Trial Registration ISRCTN Registry ISRCTN48317451; http://www.isrctn.com/ISRCTN48317451 (Archived by WebCite at http://www.webcitation.org/779tKLsu3) International Registered Report Identifier (IRRID) PRR1-10.2196/13119
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Affiliation(s)
- Marcus Bendtsen
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Jim McCambridge
- Department of Health Sciences, University of York, York, United Kingdom
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Müssener U, Linderoth C, Bendtsen M. Exploring the Experiences of Individuals Allocated to a Control Setting: Findings From a Mobile Health Smoking Cessation Trial. JMIR Hum Factors 2019; 6:e12139. [PMID: 30938682 PMCID: PMC6465977 DOI: 10.2196/12139] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 12/05/2018] [Accepted: 12/29/2018] [Indexed: 11/13/2022] Open
Abstract
Background Tobacco smoking is the primary cause of preventable premature disease and death worldwide. Evidence of the efficacy of text messaging interventions to reduce smoking behavior is well established, but there is still a need for studies targeting young people, especially because young adult smokers are less likely to seek treatment than older adults. A mobile health intervention, Nicotine Exit (NEXit), targeting smoking among university students was developed to support university students to quit smoking. Short-term effectiveness was measured through a randomized controlled trial, which found that immediately after the 12-week intervention, 26% of smokers in the intervention group had prolonged abstinence compared with 15% in the control group. Objective The objective of this study was to explore the experience of being allocated to the control group in the NEXit smoking cessation intervention. Methods We asked students who were allocated to the control group in the main NEXit randomized controlled trial to report their experiences. An email was sent to the participants with an electronic link to a short questionnaire. We assessed the distribution of the responses to the questionnaire by descriptive analysis. We analyzed free-text comments to 4 questions. Results The response rate for the questionnaire was 33.8% (258/763), and we collected 143 free-text comments. Of the responders, 60.9% (157/258) experienced frustration, disappointment, and irritation about being allocated to the control group; they felt they were being denied support by having to wait for the intervention. Monthly text messages during the waiting period thanking them for taking part in the trial were perceived as negative by 72.3% (189/258), but for some the messages served as a reminder about the decision to quit smoking. Of the responders, 61.2% (158/258) chose to wait to quit smoking until they had access to the intervention, and 29.8% (77/258) decided to try to quit smoking without support. Of the respondents, 77.5% (200/258) claimed they were still smoking and had signed up or were thinking about signing up for the smoking cessation program at the time of the questionnaire. Conclusions Most of the respondents reported negative feelings about having to wait for the support of the intervention and that they had decided to continue smoking. A similar number decided to wait to quit smoking until they had access to the intervention, and these respondents reported a high interest in the intervention. Free-text comments indicated that some control group participants believed that they had been excluded from the trial, while others were confused when asked to sign up for the intervention again. Trial Registration ISRCTN Registry ISRCTN75766527; http://www.isrctn.com/ISRCTN75766527 (Archived by WebCite at http://www.webcitation.org/7678sUKbR)
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Affiliation(s)
- Ulrika Müssener
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Catharina Linderoth
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Marcus Bendtsen
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Bendtsen M, Linderoth C, Bendtsen P. Mobile Phone-Based Smoking-Cessation Intervention for Patients Undergoing Elective Surgery: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e12511. [PMID: 30912757 PMCID: PMC6454332 DOI: 10.2196/12511] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 11/28/2018] [Accepted: 12/20/2018] [Indexed: 12/03/2022] Open
Abstract
Background Several large studies have shown that the risk of cardiovascular, respiratory, and wound-healing complications (including death) within 30 days of surgery is greater for smokers than for nonsmokers. However, there is evidence that even short-term perioperative smoking cessation may reduce postoperative morbidity. Over the past few years, it has become more evident that short message service (SMS)–based interventions can help individuals quit smoking. Objective The overall aim of this project is to fill the knowledge gap on whether an SMS-based smoking-cessation intervention can be effective in helping patients stop smoking perioperatively. The aim of this trial is to evaluate the effectiveness of an SMS-based intervention on smoking behavior of patients undergoing elective surgery. Methods A two-arm parallel-group randomized controlled trial will be conducted at 20 surgical departments in southeast Sweden. Smokers undergoing elective surgery who own a mobile phone will be included. Power calculations indicate that it will be necessary to randomize 434 participants. One group will be given access to a novel 12-week SMS program, which includes daily SMS messages with behavior change–enforcing text content and hyperlinks to interactive modules, while the other group will not be given access to the intervention. Both groups will have access to the surgical departments’ current routine for smoking cessation prior to surgery. Primary outcome measures, prolonged abstinence, and point prevalence of smoking cessation will be measured through questionnaires at 3, 6, and 12 months after randomization. Logistic regression models adjusted using baseline characteristics will be explored to identify potential effects of the intervention. Results Recruitment started in late October 2018 and is expected to last for a maximum of 30 months. The first results are expected to be available approximately 3 months after the final date of recruitment. Conclusions Owing to the structural problems and scarcity of time and resources, patients at most Swedish surgical departments are simply instructed to quit smoking, and perhaps, referred to a primary health care clinic. An SMS-based smoking-cessation aid can be effective in helping individuals quit smoking and is a very simple and time-efficient tool for surgical departments to use. Trial Registration ISRCTN Registry ISRCTN33869008; http://www.isrctn.com/ISRCTN33869008 International Registered Report Identifier (IRRID) PRR1-10.2196/12511
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Affiliation(s)
- Marcus Bendtsen
- Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Catharina Linderoth
- Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Preben Bendtsen
- Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.,Department of Medical Specialists, Motala Hospital, Motala, Sweden
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Masaki K, Tateno H, Kameyama N, Morino E, Watanabe R, Sekine K, Ono T, Satake K, Suzuki S, Nomura A, Betsuyaku T, Fukunaga K. Impact of a Novel Smartphone App (CureApp Smoking Cessation) on Nicotine Dependence: Prospective Single-Arm Interventional Pilot Study. JMIR Mhealth Uhealth 2019; 7:e12694. [PMID: 30777848 PMCID: PMC6399570 DOI: 10.2196/12694] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 12/30/2018] [Accepted: 01/07/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Mobile apps have been considered to provide active and continuous support for smoking cessation. However, it is yet to be known whether a smoking cessation smartphone app improves long-term abstinence rates in nicotine-dependent patients. OBJECTIVE This study aimed to evaluate the long-term abstinence effect of a novel smartphone app, CureApp Smoking Cessation (CASC), in patients with nicotine dependence. METHODS In this prospective, interventional, multicenter, single-arm study, we provided the CASC app to all the participants, who used it daily for 24 weeks. The CASC app includes features to maximize the therapeutic effect of pharmacological therapies and counseling at outpatient clinics for smoking cessation. The primary endpoint was a continuous abstinence rate (CAR) from weeks 9 to 24, whereas secondary endpoints were CARs from weeks 9 to 12 and 9 to 52. RESULTS Of the 56 adult smokers recruited, 1 did not download the app; therefore, 55 participants constituted the full analysis sample. The CAR from weeks 9 to 24 was 64% (35/55, 95% CI 51%-76%), whereas the CARs from weeks 9 to 12 and 9 to 52 were 76% (42/55, 95% CI 65%-88%) and 58% (32/55, 95% CI 46%-71%), respectively. These CARs were better than the results of the national survey on outpatient clinics with regard to smoking cessation under the National Health Insurance Program and that of the varenicline phase 3 trial in Japan and the United States. There was only 1 participant who dropped out during the 12 weeks of the treatment period. This treatment decreased the scores related to withdrawal and craving symptoms. CONCLUSIONS The addition of CASC to usual smoking cessation therapies resulted in high CARs, high patient retention rates, and improvement of cessation-related symptoms. The smartphone app CASC is a feasible and useful tool to help long-term continuous abstinence that can be combined with a standard smoking cessation treatment program.
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Affiliation(s)
- Katsunori Masaki
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroki Tateno
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
- Department of Internal Medicine, Saitama City Hospital, Saitama, Japan
| | - Naofumi Kameyama
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Eriko Morino
- Department of Respiratory Medicine, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Riri Watanabe
- Department of General Internal Medicine, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kazuma Sekine
- Akao Clinic, Yokohama, Japan
- Department of Respiratory Medicine, Nippon Koukan Hospital, Kawasaki, Japan
| | | | - Kohta Satake
- CureApp Institute, Karuiwaza, Japan
- CureApp Inc, Tokyo, Japan
| | | | - Akihiro Nomura
- CureApp Institute, Karuiwaza, Japan
- Innovative Clinical Research Center, Kanazawa University, Kanazawa, Japan
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Tomoko Betsuyaku
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Koichi Fukunaga
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
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Popp J, Nyman JA, Luo X, Bengtson J, Lust K, An L, Ahluwalia JS, Thomas JL. Cost-effectiveness of enhancing a Quit-and-Win smoking cessation program for college students. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2018; 19:1319-1333. [PMID: 29687268 DOI: 10.1007/s10198-018-0977-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 04/10/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES We conducted a cost-effectiveness analysis and model-based cost-utility and cost-benefit analysis of increased dosage (3 vs. 1 consecutive contests) and enhanced content (supplemental smoking-cessation counseling) of the Quit-and-Win contest using data from a randomized control trial enrolling college students in the US. METHODS For the cost-utility and cost-benefit analyses, we used a microsimulation model of the life course of current and former smokers to translate the distribution of the duration of continuous abstinence among each treatment arm's participants observed at the end of the trial (N = 1217) into expected quality-adjusted life-years (QALYs) and costs and an incremental net monetary benefit (INMB). Missing observations in the trial were classified as smoking. For our reference case, we took a societal perspective and used a 3% discount rate for costs and benefits. A probabilistic sensitivity analysis (PSA) was performed to account for model and trial-estimated parameter uncertainty. We also conducted a cost-effectiveness analysis (cost per additional intermediate cessation) using direct costs of the intervention and two trial-based estimates of intermediate cessation: (a) biochemically verified (BV) 6-month continuous abstinence and (b) BV 30-day point prevalence abstinence at 6 months. RESULTS Multiple contests resulted in a significantly higher BV 6-month continuous abstinence rate (RD 0.04), at a cost of $1275 per additional quit, and increased the duration of continuous abstinence among quitters. In the long run, multiple contests lead to an average gain of 0.03 QALYs and were cost saving. Incorporating parameter uncertainty into the analyses, the expected INMB was greater than $1000 for any realistic willingness to pay (WTP) for a QALY. CONCLUSIONS Assuming missing values were smoking, multiple contests appear to dominate a single contest from a societal perspective. Funding agencies seeking to promote population health by funding a Quit-and-Win contest in a university setting should strongly consider offering multiple consecutive contests. Further research is needed to evaluate multiple contests compared to no contest.
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Affiliation(s)
- Jonah Popp
- Division of Health Policy and Management, School of Public Health, University of Minnesota, 420 Delaware Street SE, MMC 729, Minneapolis, MN, 55414, USA.
| | - John A Nyman
- Division of Health Policy and Management, School of Public Health, University of Minnesota, 420 Delaware Street SE, MMC 729, Minneapolis, MN, 55414, USA
| | - Xianghua Luo
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN, USA
| | - Jill Bengtson
- Division of General Internal Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Katherine Lust
- Boynton Health Service, University of Minnesota, Minneapolis, MN, USA
| | - Lawrence An
- Center for Health Communications Research, University of Michigan, Ann Arbor, MI, USA
| | | | - Janet L Thomas
- Division of General Internal Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
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Thomas K, Bendtsen M, Linderoth C, Müssener U. mHealth smoking cessation intervention among high-school pupils (NEXit Junior): study protocol for a randomized controlled trial. Trials 2018; 19:648. [PMID: 30466484 PMCID: PMC6249762 DOI: 10.1186/s13063-018-3028-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 10/29/2018] [Indexed: 11/16/2022] Open
Abstract
Background Mobile health (mHealth) interventions, using text messages to support high-school pupils to quit smoking, could be a novel and cost-effective approach. However, more research is needed, specifically to investigate long-term effectiveness. The study aims to evaluate the effectiveness of a newly developed mHealth intervention targeting smoking cessation among high-school pupils. Methods The study is a two-arm, randomized controlled trial with an intervention group (mHealth intervention) and a control group (treatment as usual: national smoking cessation help line). Outcome measures will be investigated at baseline and at 3, 6, and 12 months’ follow-up. Primary outcome measures will be: prolonged abstinence and 4-week point prevalence of smoking abstinence. Secondary outcome measures will be: 7-day point prevalence of smoking abstinence; mean number of quit attempts since taking part in the study; number of uses of other smoking cessation services since first invitation to the study and number of cigarettes smoked weekly if still smoking. Discussion High schools in Sweden are bound by law to offer a smoke-free environment. However, little effort has been made to offer support to pupils who wish to quit smoking; rather the emphasis is on prevention of uptake. The study will examine the effectiveness of a stand-alone mHealth intervention targeting smokers among high-school pupils. Trial registration The trial was not retrospectively registered and has been registered at ISRCTN with the unique identification number ISRCTN15396225. The trial was registered on 13 October 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-3028-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kristin Thomas
- Department of Medical and Health Sciences, Faculty of Medicine and Health, Linköping University, Linköping, Sweden
| | - Marcus Bendtsen
- Department of Medical and Health Sciences, Faculty of Medicine and Health, Linköping University, Linköping, Sweden.
| | - Catharina Linderoth
- Department of Medical and Health Sciences, Faculty of Medicine and Health, Linköping University, Linköping, Sweden
| | - Ulrika Müssener
- Department of Medical and Health Sciences, Faculty of Medicine and Health, Linköping University, Linköping, Sweden
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Bendtsen M. A Gentle Introduction to the Comparison Between Null Hypothesis Testing and Bayesian Analysis: Reanalysis of Two Randomized Controlled Trials. J Med Internet Res 2018; 20:e10873. [PMID: 30148453 PMCID: PMC6231868 DOI: 10.2196/10873] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 08/07/2018] [Accepted: 08/07/2018] [Indexed: 11/13/2022] Open
Abstract
The debate on the use and misuse of P values has risen and fallen throughout their almost century-long existence in scientific discovery. Over the past few years, the debate has again received front-page attention, particularly through the public reminder by the American Statistical Association on how P values should be used and interpreted. At the core of the issue lies a fault in the way that scientific evidence is dichotomized and research is subsequently reported, and this fault is exacerbated by researchers giving license to statistical models to do scientific inference. This paper highlights a different approach to handling the evidence collected during a randomized controlled trial, one that does not dichotomize, but rather reports the evidence collected. Through the use of a coin flipping experiment and reanalysis of real-world data, the traditional approach of testing null hypothesis significance is contrasted with a Bayesian approach. This paper is meant to be understood by those who rely on statistical models to draw conclusions from data, but are not statisticians and may therefore not be able to grasp the debate that is primarily led by statisticians.
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Affiliation(s)
- Marcus Bendtsen
- Division of Community Medicine, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Do HP, Tran BX, Le Pham Q, Nguyen LH, Tran TT, Latkin CA, Dunne MP, Baker PR. Which eHealth interventions are most effective for smoking cessation? A systematic review. Patient Prefer Adherence 2018; 12:2065-2084. [PMID: 30349201 PMCID: PMC6188156 DOI: 10.2147/ppa.s169397] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
PURPOSE To synthesize evidence of the effects and potential effect modifiers of different electronic health (eHealth) interventions to help people quit smoking. METHODS Four databases (MEDLINE, PsycINFO, Embase, and The Cochrane Library) were searched in March 2017 using terms that included "smoking cessation", "eHealth/mHealth" and "electronic technology" to find relevant studies. Meta-analysis and meta-regression analyses were performed using Mantel-Haenszel test for fixed-effect risk ratio (RR) and restricted maximum-likelihood technique, respectively. Protocol Registration Number: CRD42017072560. RESULTS The review included 108 studies and 110,372 participants. Compared to nonactive control groups (eg, usual care), smoking cessation interventions using web-based and mobile health (mHealth) platform resulted in significantly greater smoking abstinence, RR 2.03 (95% CI 1.7-2.03), and RR 1.71 (95% CI 1.35-2.16), respectively. Similarly, smoking cessation trials using tailored text messages (RR 1.80, 95% CI 1.54-2.10) and web-based information and conjunctive nicotine replacement therapy (RR 1.29, 95% CI 1.17-1.43) may also increase cessation. In contrast, little or no benefit for smoking abstinence was found for computer-assisted interventions (RR 1.31, 95% CI 1.11-1.53). The magnitude of effect sizes from mHealth smoking cessation interventions was likely to be greater if the trial was conducted in the USA or Europe and when the intervention included individually tailored text messages. In contrast, high frequency of texts (daily) was less effective than weekly texts. CONCLUSIONS There was consistent evidence that web-based and mHealth smoking cessation interventions may increase abstinence moderately. Methodologic quality of trials and the intervention characteristics (tailored vs untailored) are critical effect modifiers among eHealth smoking cessation interventions, especially for web-based and text messaging trials. Future smoking cessation intervention should take advantages of web-based and mHealth engagement to improve prolonged abstinence.
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Affiliation(s)
- Huyen Phuc Do
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia,
- Institute for Global Health Innovations, Duy Tan University, Danang, Vietnam,
| | - Bach Xuan Tran
- Department of Health, Behaviours and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Quyen Le Pham
- Department of Internal Medicine, Hanoi Medical University, Hanoi, Vietnam
| | - Long Hoang Nguyen
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Tung Thanh Tran
- Institute for Global Health Innovations, Duy Tan University, Danang, Vietnam,
| | - Carl A Latkin
- Department of Health, Behaviours and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael P Dunne
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia,
- Institute for Community Health Research, Hue University, Hue, Vietnam
| | - Philip Ra Baker
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia,
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Martínez-González C, Casanova C, de-Torres JP, Marín JM, de Lucas P, Fuster A, Cosío BG, Calle M, Peces-Barba G, Solanes I, Agüero R, Feu-Collado N, Alfageme I, Romero Plaza A, Balcells E, de Diego A, Marín Royo M, Moreno A, Llunell Casanovas A, Galdiz JB, Golpe R, Lacárcel Bautista C, Cabrera C, Marin A, Soriano JB, Lopez-Campos JL. Changes and Clinical Consequences of Smoking Cessation in Patients With COPD. Chest 2018; 154:274-285. [DOI: 10.1016/j.chest.2018.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2017] [Revised: 12/27/2017] [Accepted: 02/01/2018] [Indexed: 10/18/2022] Open
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Gopinathan P, Kaur J, Joshi S, Prasad VM, Pujari S, Panda P, Murthy P. Self-reported quit rates and quit attempts among subscribers of a mobile text messaging-based tobacco cessation programme in India. ACTA ACUST UNITED AC 2018. [DOI: 10.1136/bmjinnov-2018-000285] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
IntroductionIn 2015, as part of the WHO and International Telecommunication Union’s ‘Be Healthy Be Mobile’ initiative using mobile technology to combat non-communicable diseases, the Ministry of Health and Family Welfare and the Ministry of Communication and Information Technology in India developed a short text message-based mobile health programme (the ‘mCessation’ programme) to support tobacco users to quit tobacco use.ObjectivesTo evaluate the effectiveness of the mCessation programme by estimating quit rates and quit attempts among registered subscribers of the programme and to understand subscriber perceptions of the programme.MethodsSubscribers to the mCessation (QuitNow) programme were telephonically interviewed 4–6 months after registration. A total of 12 502 calls were made, and completed responses recorded from 3362 ever tobacco users. A total of 6978 respondents either gave very few responses or refused to participate in the telephonic survey. Never tobacco users (1935) and subscribers to the mDiabetes programme (227) were excluded from the sample.ResultsA large proportion of registrants (1935 out of 12 502 respondents) were found to be never users. The quit rate (estimated as those who stated they had not had any tobacco in the past 30 days at 4–6 months after registering with the programme from the total sample (excluding never smokers and mDiabetes registrants)) was 19%. Sixty-six per cent of registered subscribers who were current tobacco users had made quit attempts in the period between registration and survey. Seventy-seven per cent of respondents reported that the programme was helpful/very helpful to quit tobacco.ConclusionThe mCessation programme has successfully helped tobacco users in India to quit tobacco by motivating and supporting registered participants through mobile text messages.
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Müssener U, Thomas K, Linderoth C, Leijon M, Bendtsen M. A Text Message-Based Intervention Targeting Alcohol Consumption Among University Students: User Satisfaction and Acceptability Study. JMIR Hum Factors 2018; 5:e23. [PMID: 29991469 PMCID: PMC6058091 DOI: 10.2196/humanfactors.9641] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 04/03/2018] [Accepted: 05/10/2018] [Indexed: 12/20/2022] Open
Abstract
Background Heavy consumption of alcohol among university students is a global problem, with excessive drinking being the social norm. Students can be a difficult target group to reach, and only a minority seek alcohol-related support. It is important to develop interventions that can reach university students in a way that does not further stretch the resources of the health services. Text messaging (short message service, SMS)–based interventions can enable continuous, real-time, cost-effective, brief support in a real-world setting, but there is a limited amount of evidence for effective interventions on alcohol consumption among young people based on text messaging. To address this, a text messaging–based alcohol consumption intervention, the Amadeus 3 intervention, was developed. Objective This study explored self-reported changes in drinking habits in an intervention group and a control group. Additionally, user satisfaction among the intervention group and the experience of being allocated to a control group were explored. Methods Students allocated to the intervention group (n=460) were asked about their drinking habits and offered the opportunity to give their opinion on the structure and content of the intervention. Students in the control group (n=436) were asked about their drinking habits and their experience in being allocated to the control group. Participants received an email containing an electronic link to a short questionnaire. Descriptive analyses of the distribution of the responses to the 12 questions for the intervention group and 5 questions for the control group were performed. Results The response rate for the user feedback questionnaire of the intervention group was 38% (176/460) and of the control group was 30% (129/436). The variation in the content of the text messages from facts to motivational and practical advice was appreciated by 77% (135/176) participants, and 55% (97/176) found the number of messages per week to be adequate. Overall, 81% (142/176) participants stated that they had read all or nearly all the messages, and 52% (91/176) participants stated that they were drinking less, and increased awareness regarding negative consequences was expressed as the main reason for reduced alcohol consumption. Among the participants in the control group, 40% (52/129) stated that it did not matter that they had to wait for access to the intervention. Regarding actions taken while waiting for access, 48% (62/129) participants claimed that they continued to drink as before, whereas 35% (45/129) tried to reduce their consumption without any support. Conclusions Although the main randomized controlled trial was not able to detect a statistically significant effect of the intervention, most participants in this qualitative follow-up study stated that participation in the study helped them reflect upon their consumption, leading to altered drinking habits and reduced alcohol consumption. Trial Registration International Standard Randomized Controlled Trial Number ISRCTN95054707; http://www.isrctn.com/ISRCTN95054707 (Archived by WebCite at http://www.webcitation.org/705putNZT)
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Affiliation(s)
- Ulrika Müssener
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Kristin Thomas
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Catharina Linderoth
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Matti Leijon
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Marcus Bendtsen
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Haug S, Paz Castro R, Meyer C, Filler A, Kowatsch T, Schaub MP. A Mobile Phone-Based Life Skills Training Program for Substance Use Prevention Among Adolescents: Pre-Post Study on the Acceptance and Potential Effectiveness of the Program, Ready4life. JMIR Mhealth Uhealth 2017; 5:e143. [PMID: 28978498 PMCID: PMC5647461 DOI: 10.2196/mhealth.8474] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 08/10/2017] [Accepted: 08/10/2017] [Indexed: 01/02/2023] Open
Abstract
Background Substance use and misuse often first emerge during adolescence. Generic life skills training that is typically conducted within the school curriculum is effective at preventing the onset and escalation of substance use among adolescents. However, the dissemination of such programs is impeded by their large resource requirements in terms of personnel, money, and time. Life skills training provided via mobile phones might be a more economic and scalable approach, which additionally matches the lifestyle and communication habits of adolescents. Objective The aim of this study was to test the acceptance and initial effectiveness of an individually tailored mobile phone–based life skills training program in vocational school students. Methods The fully automated program, named ready4life, is based on social cognitive theory and addresses self-management skills, social skills, and substance use resistance skills. Program participants received up to 3 weekly text messages (short message service, SMS) over 6 months. Active program engagement was stimulated by interactive features such as quiz questions, message- and picture-contests, and integration of a friendly competition with prizes in which program users collected credits with each interaction. Generalized estimating equation (GEE) analyses were used to investigate for changes between baseline and 6-month follow-up in the following outcomes: perceived stress, self-management skills, social skills, at-risk alcohol use, tobacco smoking, and cannabis use. Results The program was tested in 118 school classes at 13 vocational schools in Switzerland. A total of 1067 students who owned a mobile phone and were not regular cigarette smokers were invited to participate in the life skills program. Of these, 877 (82.19%, 877/1067; mean age=17.4 years, standard deviation [SD]=2.7; 58.3% females) participated in the program and the associated study. A total of 43 students (4.9%, 43/877) withdrew their program participation during the intervention period. The mean number of interactive program activities that participants engaged in was 15.5 (SD 13.3) out of a total of 39 possible activities. Follow-up assessments were completed by 436 of the 877 (49.7%) participants. GEE analyses revealed decreased perceived stress (odds ratio, OR=0.93; 95% CI 0.87-0.99; P=.03) and increases in several life skills addressed between baseline and the follow-up assessment. The proportion of adolescents with at-risk alcohol use declined from 20.2% at baseline to 15.5% at follow-up (OR 0.70, 95% CI 0.53-0.93; P=.01), whereas no significant changes were obtained for tobacco (OR 0.94, 95% CI 0.65-1.36; P=.76) or cannabis use (OR 0.91, 95% CI 0.67-1.24; P=.54). Conclusions These results reveal high-level acceptance and promising effectiveness of this interventional approach, which could be easily and economically implemented. A reasonable next step would be to test the efficacy of this program within a controlled trial.
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Affiliation(s)
- Severin Haug
- Swiss Research Institute for Public Health and Addiction at the University of Zurich, Zurich University, Zurich, Switzerland
| | - Raquel Paz Castro
- Swiss Research Institute for Public Health and Addiction at the University of Zurich, Zurich University, Zurich, Switzerland
| | - Christian Meyer
- Institute of Social Medicine and Prevention, University of Greifswald, Greifswald, Germany
| | - Andreas Filler
- Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland.,Energy Efficient Systems Group, University of Bamberg, Bamberg, Germany
| | - Tobias Kowatsch
- Centre for Digital Health Interventions, Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Michael P Schaub
- Swiss Research Institute for Public Health and Addiction at the University of Zurich, Zurich University, Zurich, Switzerland
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mHealth Intervention is Effective in Creating Smoke-Free Homes for Newborns: A Randomized Controlled Trial Study in China. Sci Rep 2017; 7:9276. [PMID: 28860461 PMCID: PMC5578962 DOI: 10.1038/s41598-017-08922-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 07/13/2017] [Indexed: 01/31/2023] Open
Abstract
Mobile-phone-based smoking cessation intervention has been shown to increase quitting among smokers. However, such intervention has not yet been applied to secondhand smoke (SHS) reduction programs that target smoking parents of newborns. This randomized controlled trial, undertaken in Changchun, China, assessed whether interventions that incorporate traditional and mobile-phone-based education will help create smoke-free homes for infants and increase quitting among fathers. The results showed that the abstinence rates of the fathers at 6 months (adjusted OR: 3.60, 95% CI: 1.41-9.25; p = 0.008) and 12 months (adjusted OR: 2.93, 95% CI: 1.24-6.94; p = 0.014) were both significantly increased in the intervention group compared to the control. Mothers of the newborns in the intervention group also reported reduced exposure to SHS at 12 months (adjusted OR: 0.53, 95% CI: 0.29-0.99; p = 0.046). The findings suggest that adding mHealth interventions to traditional face-to-face health counseling may be an effective way to increase male smoking cessation and reduce mother and newborn SHS exposure in the home.
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Schick RS, Kelsey TW, Marston J, Samson K, Humphris GW. MapMySmoke: feasibility of a new quit cigarette smoking mobile phone application using integrated geo-positioning technology, and motivational messaging within a primary care setting. Pilot Feasibility Stud 2017; 4:19. [PMID: 28725452 PMCID: PMC5513177 DOI: 10.1186/s40814-017-0165-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 06/25/2017] [Indexed: 11/20/2022] Open
Abstract
Background Approximately 11,000 people die in Scotland each year as a result of smoking-related causes. Quitting smoking is relatively easy; maintaining a quit attempt is a very difficult task with success rates for unaided quit attempts stubbornly remaining in the single digits. Pharmaceutical treatment can improve these rates by lowering the overall reward factor of nicotine. However, these and related nicotine replacement therapies do not operate on, or address, the spatial and contextual aspects of smoking behaviour. With the ubiquity of smartphones that can log spatial, quantitative and qualitative data related to smoking behaviour, there exists a person-centred clinical opportunity to support smokers attempting to quit by first understanding their smoking behaviour and subsequently sending them dynamic messages to encourage health behaviour change within a situational context. Methods We have built a smartphone app—MapMySmoke—that works on Android and iOS platforms. The deployment of this app within a clinical National Health Service (NHS) setting has two distinct phases: (1) a 2-week logging phase where pre-quit patients log all of their smoking and craving events; and (2) a post-quit phase where users receive dynamic support messages and can continue to log craving events, and should they occur, relapse events. Following the initial logging phase, patients consult with their general practitioner (GP) or healthcare provider to review their smoking patterns and to outline a precise, individualised quit attempt plan. Our feasibility study consists of assessment of an initial app version during and after use by eight patients recruited from an NHS Fife GP practice. In addition to evaluation of the app as a potential smoking cessation aid, we have assessed the user experience, technological requirements and security of the data flow. Results In an initial feasibility study, we have deployed the app for a small number of patients within one GP practice in NHS Fife. We recruited eight patients within one surgery, four of whom actively logged information about their smoking behaviour. Initial feedback was very positive, and users indicated a willingness to log their craving and smoking events. In addition, two out of three patients who completed follow-up interviews noted that the app helped them reduce the number of cigarettes they smoked per day, while the third indicated that it had helped them quit. The study highlighted the use of pushed notifications as a potential technology for maintaining quit attempts, and the security of collection of data was audited. These initial results influenced the design of a planned second larger study, comprised of 100 patients, the primary objectives of which are to use statistical modelling to identify times and places of probable switches into smoking states, and to target these times with dynamic health behaviour messaging. Conclusions While the health benefits of quitting smoking are unequivocal, such behaviour change is very difficult to achieve. Many factors are likely to contribute to maintaining smoking behaviour, yet the precise role of cues derived from the spatial environment remains unclear. The rise of smartphones, therefore, allows clinicians the opportunity to better understand the spatial aspects of smoking behaviour and affords them the opportunity to push targeted individualised health support messages at vulnerable times and places. Trial registration ClinicalTrial.gov, NCT02932917.
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Affiliation(s)
- Robert S Schick
- School of Mathematics and Statistics, The Observatory, University of St Andrews, Buchanan Gardens, St Andrews, KY16 9LZ UK.,Marine Geospatial Ecology Lab, Nicholas School of the Environment, Duke University, Durham, NC 27708 USA
| | - Thomas W Kelsey
- School of Computer Science, University of St Andrews, North Haugh, St Andrews, KY16 9SX UK
| | - John Marston
- Dr Kyle and Partners Surgery, 2 Routine Row, Pittenweem, Anstruther KY10 2LG UK
| | - Kay Samson
- NHS Fife Smoking Cessation Services, Cameron Hospital, Leven, KY8 5RR UK
| | - Gerald W Humphris
- School of Medicine, Medical and Biological Sciences, University of St Andrews, North Haugh, St Andrews, KY16 9TF UK
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Digital Health Technologies to Promote Lifestyle Change and Adherence. CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2017. [DOI: 10.1007/s11936-017-0560-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Widmer RJ, Allison TG, Lennon R, Lopez-Jimenez F, Lerman LO, Lerman A. Digital health intervention during cardiac rehabilitation: A randomized controlled trial. Am Heart J 2017; 188:65-72. [PMID: 28577682 DOI: 10.1016/j.ahj.2017.02.016] [Citation(s) in RCA: 98] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 02/06/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Digital health interventions (DHI) have been shown to improve intermediates of cardiovascular health, but their impact on cardiovascular (CV) outcomes has not been fully explored. The aim of this study was to determine whether DHI administered during cardiac rehabilitation (CR) would reduce CV-related emergency department (ED) visits and rehospitalizations in patients after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). METHODS We randomized patients undergoing CR following ACS and PCI to standard CR (n=40) or CR+DHI (n=40) for 3 months with 3 patients withdrawing from CR prior to initiation in the treatment arm and 6 in the control group. The DHI incorporated an online and smartphone-based CR platform asking the patients to report of dietary and exercise habits throughout CR as well as educational information toward patients' healthy lifestyles. We obtained data regarding ED visits and rehospitalizations at 180 days, as well as other metrics of secondary CV prevention at baseline and 90 days. RESULTS Baseline demographics were similar between the groups. The DHI+CR group had improved weight loss compared to the control group (-5.1±6.5 kg vs. -0.8±3.8 kg, respectively, P=.02). Those in the DHI+CR group also showed a non-significant reduction in CV-related rehospitalizations plus ED visits compared to the control group at 180 days (8.1% vs 26.6%; RR 0.30, 95% CI 0.08-1.10, P=.054). CONCLUSIONS The current study demonstrated that complementary DHI significantly improves weight loss, and might offer a method to reduce CV-related ED visits plus rehospitalizations in patients after ACS undergoing CR. The study suggests a role for DHI as an adjunct to CR to improve secondary prevention of CV disease. TRIAL REGISTRATION This trial is registered at clinicaltrials.gov (NCT01883050).
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Affiliation(s)
- R Jay Widmer
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA
| | - Thomas G Allison
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA
| | - Ryan Lennon
- Division of Biostatistics, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA
| | - Francisco Lopez-Jimenez
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA
| | - Amir Lerman
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA.
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Müssener U, Bendtsen M, McCambridge J, Bendtsen P. User satisfaction with the structure and content of the NEXit intervention, a text messaging-based smoking cessation programme. BMC Public Health 2016; 16:1179. [PMID: 27876031 PMCID: PMC5118888 DOI: 10.1186/s12889-016-3848-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Accepted: 11/15/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Smoking is still the leading cause of preventable ill health and death. There is a limited amount of evidence for effective smoking cessation interventions among young people. To address this, a text messaging-based smoking cessation programme, the NEXit intervention, was developed. Short-term effectiveness, measured immediately after the 12-week intervention revealed that 26% of smokers in the intervention group had prolonged abstinence compared with 15% in the control group. The present study was performed to explore the users' experiences of the structure and content of the intervention in order to further develop the intervention. METHODS Students participating in the main NEXit randomized controlled trial were invited to grade their experiences of the structure and content of the intervention after having completed follow-up. The participants received an e-mail with an electronic link to a short questionnaire. Descriptive analysis of the distribution of the responses to the questionnaire was performed. Free-text comments to 14 questions were analysed. RESULTS The response rate for the user feedback questionnaire was 35% (n = 289/827) and 428 free-text comments were collected. The first motivational phase of the intervention was appreciated by 55% (158/289) of the participants. Most participants wanted to quit smoking immediately and only 124/289 (43%) agreed to have to decide a quit-date in the future. Most participants 199/289 (69%) found the content of the messages in the core programme to be very good or good, and the variability between content types was appreciated by 78% (224/289). Only 34% (97/289) of the participants thought that all or nearly all messages were valuable, and some mentioned that it was not really the content that mattered, but that the messages served as a reminder about the decision to quit smoking. CONCLUSIONS The programme was largely perceived satisfactory in most aspects concerning structure and content by young people and most participants stated that they would recommend it to a friend who wants to quit smoking. The motivational phase might be worth shortening and the number of messages around the quit date itself reduced. Shorter messages seemed to be more acceptable. TRIAL REGISTRATION ISRCTN75766527 .
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Affiliation(s)
- Ulrika Müssener
- Department of Medical and Health Sciences, Linköping University, Linköping, 581 83, Sweden.
| | - Marcus Bendtsen
- Department of Computer and Information Science, Linköping University, Linköping, 581 83, Sweden
| | - Jim McCambridge
- Department of Medical and Health Sciences, Linköping University, Linköping, 581 83, Sweden.,Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK
| | - Preben Bendtsen
- Department of Medical Specialist and Department of Medical and Health Sciences, Motala, Linköping University, Linköping, 581 83, Sweden
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Abstract
PURPOSE OF REVIEW Addictive behaviors among college students are a significant public health concern. This manuscript reviews the past two years of literature on prevention and treatment approaches for college students who engage in addictive behaviors. RECENT FINDINGS In-person skills-based interventions and motivational interventions that incorporate personalized feedback are effective in the short-term but little support was found for long-term effects. Although web-based interventions reduced certain addictive behaviors (e.g., alcohol, problematic gambling), in-person interventions that include motivational interviewing components and personalized feedback appear to be more efficacious. SUMMARY Research has largely focused on alcohol and little is known about the utility of interventions for students who use tobacco or illicit substances or who engage in problematic gambling. Research on interventions for these high-risk behaviors is recommended.
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Liao Y, Wu Q, Tang J, Zhang F, Wang X, Qi C, He H, Long J, Kelly BC, Cohen J. The efficacy of mobile phone-based text message interventions ('Happy Quit') for smoking cessation in China. BMC Public Health 2016; 16:833. [PMID: 27543164 PMCID: PMC4992272 DOI: 10.1186/s12889-016-3528-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/17/2016] [Indexed: 11/25/2022] Open
Abstract
Background Considering the extreme shortage of smoking cessation services in China, and the acceptability, feasibility and efficacy of mobile phone-based text message interventions for quitting smoking in other countries, here we propose a study of “the efficacy of mobile phone-based text message interventions (‘Happy Quit’) for smoking cessation in China”. The primary objective of this proposed project is to assess whether a program of widely accessed mobile phone-based text message interventions (‘Happy Quit’) will be effective at helping people in China who smoke, to quit. Based on the efficacy of previous studies in smoking cessation, we hypothesize that ‘Happy Quit’ will be an effective, feasible and affordable smoking cessation program in China. Methods/Design In this single-blind, randomized trial, undertaken in China, about 2000 smokers willing to make a quit attempt will be randomly allocated, using an independent telephone randomization system that includes a minimization algorithm balancing for sex (male, female), age (19–34 or >34 years), educational level (≤ or >12 years), and Fagerstrom score for nicotine addiction (≤5, >5), to ‘Happy Quit’, comprising motivational messages and behavioral-change support, or to a control group that receives text messages unrelated to quitting. Messages will be developed to be suitable for Chinese. A pilot study will be conducted before the intervention to modify the library of messages and interventions. The primary outcome will be self-reported continuous smoking abstinence. A secondary outcome will be point prevalence of abstinence. Abstinence will be assessed at six time points (4, 8, 12, 16, 20 and 24 weeks post-intervention). A third outcome will be reductions in number of cigarettes smoked per day. Discussion/Implications The results will provide valuable insights into bridging the gap between need and services received for smoking cessation interventions and tobacco use prevention in China. It will also serve as mHealth model for extending the public health significance of other interventions, such as mental health interventions. Trial registration NCT02693626 (Registration data April 11, 2016).
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Affiliation(s)
- Yanhui Liao
- Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China. .,Department of Psychiatry and Biobehavioral Sciences, UCLA, 760 Westwood Plaza, Los Angeles, CA, 90095, USA.
| | - Qiuxia Wu
- Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China
| | - Jinsong Tang
- Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China.,Department of Psychiatry and Biobehavioral Sciences, UCLA, 760 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Fengyu Zhang
- Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China
| | - Xuyi Wang
- Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China
| | - Chang Qi
- Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China
| | - Haoyu He
- Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China
| | - Jiang Long
- Mental Health Institute of the Second Xiangya Hospital, Central South University. National Clinical Research Center on Mental Disorders & National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, China
| | - Brian C Kelly
- Department of Sociology & Center for Research on Young People's Health (CRYPH), Purdue University, 700 W State Street, West Lafayette, IN, 47907, USA.
| | - Joanna Cohen
- Institute for Global Tobacco Control (IGTC) at Johns Hopkins Bloomberg School of Public Health, 2213 McElderry St., Fourth Floor, Baltimore, MD, 21205, USA
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